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Flashcards in pneumonia Deck (15):
1

aetiology

community acquired
hospital acquired
atypical
immunocompromised
aspiration
recurrent

2

what types of organisms cause pneumonia

strep pneumoniae - 36%

H influenzae - 10.2%

legionella ssp

mycoplasma pneumoniae

staph aureus

viral viruses - 13.1%

3

pathology

acute lower resp tract infection affecting he lung parenchyma

4

what happens in bronchopneumonia

diffuse throughout lung
bugs in bronchioles = inflammation = patches of pus

patchy opacification on CXR

5

what happens in segmental/lobar pneumonia

pneumonia in specific lobe of the lung

localised opacification on CXR

6

symptoms

malaise
fever
pleuritic chest pain
cough
purulent sputum
duspnoea

7

signs

tachypnoea
tachycardia
central cyanosis
dullness on percussion of affected lobes
bronchial breath sounds
inspiratory crackles
increased vocal resonance
decreased chest expansion

8

tests

U&E - CRP - LFT - FBC - ABG
CXR (Shadowing/Consolidation)
Blood Cultures
Throat Swab
Urinary Legionella Antigen
Sputum microscopy/culture

CURB 65

9

what are the different aspects of CURB 65

C - confusion
U - Blood Urea>7mmol/L
R - Resp. Rate > 30
B - BP Diastolic < 60 or Systolic < 90
65 - Age > 65

10

what is the scoring for CURB 65

0 = Low risk, treated in community
1-2 = Hospital Treatment
3-5 = High death risk/ITU

11

what is the management of pneumonia

Antibiotics - based on CURB65 score

Add Flucloxacillin if Staph Aureus & Vancomycin if MRSA

IV Fluids
O2
Continuous Positive Airway Pressure (CPAP)
Intubation/Ventilation

Analgesia if pleurisy causing pain (e.g. paracetamol)

12

what are the specific antibiotics for the different CURB65 scores

0-1 = Amoxicillin or Clarithromycin/Doxycycline

2 = Amoxicillin and Clarithromycin/Levofloxacin

3-5 = Co-Amoxiclav and Clarithromycin/Levofloxacin
(Levofloxacin if penicillin allergic)


Add Flucloxacillin if Staph Aureus & Vancomycin if MRSA

13

what are the Dx for pneumonia

TB
lung cancer
PE
cardiac failure
pulmonary vasculitis

14

what are the possible outcomes of pneumonia

Resolves

Pleurisy/effusion/empyema

Organisation & scarring (cryptogenic organising pneumonia)

Lung Abscess (painful collection of pus under pressure in the lung)

Bronchiectasis (infection & scarring leads to abnormal dilated airways)

15

what are the complications of pneumonia

septicaemia
acute kidney injury
empyema
lung abscess
haemolytic anaemia
ARDS